Gluteal mass in a bodybuilder: radiological depiction of a complication of anabolic steroid use

The use of anabolic steroids by bodybuilders is relatively common and associated with many side effects. Local side effects include tissue necrosis and soft tissue infection at the injection site. Systemic effects may be early epiphyseal closure in the immature skeleton, testicular atrophy, sterility, acne, gynaecomastia and liver disorders such as hepatitis. We report an unusual case of a bodybuilder who developed a large painful inflammatory soft tissue mass in his gluteal area. Multimodality imaging showed direct evidence revealing the underlying cause of the mass being depot steroid injections.